Category Archives: Health Care

Trends in the Distribution of Health Care Financing across Developed Countries: The Role of Political Economy of States

Source: Sule Calikoglu, International Journal of Health Services, Volume 39, Number 1, 2009
(subscription required)

From the abstract:
Since the 1980s, major health care reforms in many countries have focused on redefining the boundaries of government through increasing emphasis on private sources of finance and delivery of health care. Apart from managerial and financial choices, the reliance on private sources reflects the political character of a country. This article explores whether the public-private mix of health care financing differs according to political traditions in a sample of 18 industrialized countries, analyzing a 30-year period. The results indicate that despite common trends in all four political traditions during the study period, the overall levels of expenditure and the rates of growth in public and private expenditures were different. Christian democratic countries had public expenditure levels as high as those in social democracies, but high levels of private expenditure differentiated them from the social democracies. Christian democratic countries also relied on both private insurance and out-of-pocket payments, while private insurance expenditures were very limited in social democratic countries. The level of public spending increased at much higher rates among ex-authoritarian countries over the 30 years, bringing these countries to the level of liberal countries by 2000.

Nursing: A Key To Patient Satisfaction

Source: Ann Kutney-Lee, Matthew D. McHugh, Douglas M. Sloane, Jeannie P. Cimiotti, Linda Flynn, Donna Felber Neff, and Linda H. Aiken, Health Affairs, Vol. 28 no. 4, published online 12 June 2009
(subscription required)

Patient satisfaction is receiving greater attention as a result of the rise in pay-for-performance (P4P) and the public release of data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. This paper examines the relationship between nursing and patient satisfaction across 430 hospitals. The nurse work environment was significantly related to all HCAHPS patient satisfaction measures. Additionally, patient-to-nurse workloads were significantly associated with patients’ ratings and recommendation of the hospital to others, and with their satisfaction with the receipt of discharge information. Improving nurses’ work environments, including nurse staffing, may improve the patient experience and quality of care.

Cost-Saving and Cost-Containment Strategies for New York State's Local Governments

Source: Thomas P. DiNapoli, Office of the State Comptroller, Division Of Local Government And School Accountability, June 2009

A number of cost-saving strategies are highlighted in the following pages, including:
• Computer Power Management
• Energy Audits
• Energy Performance Contracting
• Municipal Vehicles
• Wind and Solar Energy Production
• Wastewater and Sewage Treatment Facilities
• Street Lighting
• Payments in Lieu of Health Insurance Benefits
• Mail-order prescription drug options
• Medicaid fraud-detection software
• Co-pay rebate program
• Cook-Chill Food Preparation
• Telemedicine
• Alternative Incarceration

Hidden Health Tax: Americans Pay a Premium

Source: Kathleen Stoll and Kim Bailey, Families USA, May 2009

When the uninsured do obtain care, they struggle to pay as much as they can afford. Often, however, the uninsured cannot afford to pay the entire bill, and a portion of it goes uncompensated. To make up for these uncompensated care costs, doctors and hospitals charge insurers more for the services provided to patients who do have health coverage. In turn, the costs that are shifted to insurers are passed on in the form of higher premiums to consumers and businesses that purchase health coverage.

This cost shift to health insurance premiums is a “hidden health tax.” To quantify this “tax,” Families USA contracted with Milliman, Inc., an independent actuarial consulting firm, to analyze federal Medical Expenditure Panel Survey (MEPS) data and data from other federal and private sources. Based on these data, Milliman estimated the total national cost of uncompensated care provided to the uninsured, and it quantified that amount spread across the privately covered, non-Medicare, non-Medicaid population.
See also:
Key findings
Press release

Study Links Medical Costs and Personal Bankruptcy

Source: Catherine Arnst, Business Week, June 4, 2009

Medical problems caused 62% of all personal bankruptcies filed in the U.S. in 2007, according to a study by Harvard researchers. And in a finding that surprised even the researchers, 78% of those filers had medical insurance at the start of their illness, including 60.3% who had private coverage, not Medicare or Medicaid.

Roadblocks to Health Care: Why the Current Health Care System Does Not Work for Women

Source: Meena Seshamani, U.S. Department of Health and Human Services,, 2009

From the press release:
The report shows how our current system is leaving millions of women without the affordable, quality care they need.

Roadblocks to Health Care reports:
– 21 million women and girls are uninsured.
– In the individual insurance market, women are often charged higher premiums than men during their reproductive years. Holding other factors constant, a 22 year-old woman can be charged one and a half times the premium of a 22 year-old man.
– In a recent national survey, more than half of women (52 percent) reported delaying or avoiding needed care because of cost, compared with 39 percent of men.

To Err is Human – To Delay is Deadly

Source: Consumers Union, May 2009

From the press release:
Ten years ago, the Institute of Medicine (IOM) sounded the alarm about the widespread toll of medical errors in a groundbreaking report call “To Err is Human.” The report prompted a rush of congressional hearings and promises of reform. But in the decade since the report was published, little progress has been made implementing key reforms recommended by the IOM to improve patient safety, according to Consumers Union, the nonprofit publisher of Consumer Reports.

In a new report issued today, “To Err is Human – To Delay is Deadly,” Consumers Union detailed the lack of progress since the IOM estimated in 1999 that as many as 98,000 Americans die every year from preventable medical errors. Consumers Union’s report was released as lawmakers in Congress are working on legislation to address the rising cost of health care and expand access to coverage. Consumers Union maintains that reducing medical harm — including hospital-acquired infections and medication errors — would not only improve patient care but also provide significant costs savings to help make expanded access to health coverage possible.

Trends in Underinsurance and the Affordability of Employer Coverage, 2004-2007

Source: Jon R. Gabel, Roland McDevitt, Ryan Lore, Jeremy Pickreign, Heidi Whitmore, Tina Ding, Health Affairs, Vol. 28 no. 4, published online: 2 June 2009
(subscription required)

Out-of-pocket health care expenses for workers covered by employer-sponsored plans grew by more than one-third between 2004 and 2007, according to a Commonwealth Fund-supported study in Health Affairs. The higher costs are particularly burdensome for people who are sick or have modest incomes.

Too Great a Burden: Americans Face Rising Health Care Costs

Source: Families USA, April 2009

From the summary:
To better understand the magnitude of the health care cost crisis, Families USA commissioned The Lewin Group to analyze data from the U.S. Department of Health and Human Services and the U.S. Census Bureau that reveal how many Americans face very high health care costs. This analysis allowed us to determine how many non-elderly people are in families that will spend more than 10 percent of their pre-tax income, and more than 25 percent of their pre-tax income, on health care in 2009.
See also:
Key Findings